Nephrotic syndrome simulating chronic cardiac compression.

Abstract

This case is reported to demonstrate the manner in which the nephrotic syndrome of chronic renal disease can simulate chronic cardiac compression. The patient reported on showed the characteristic features of chronic cardiac compression and was referred to us for pericardiectomy. The clinical finding that overshadowed all other considerations was the radiographic demonstration of extensive calcification of the pericardium. The patient also had shortness of breath on exertion, ascites, edema, hepatic enlargement, auricular fibrillation, and a quiet heart. The demonstration of a relatively normal venous pressure in the upper extremity and the findings at cardiac catheterization precluded a diagnosis of dynamically significant chronic compression of the heart, and subsequent studies established the diagnosis of chronic renal disease. REPORT OF A CASE A 59-year-old white man was in good health until about four years before hospital admission, at which time he began to have periodic abdominal distention. Two years later, this